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General Medicine

Myasthenia Gravis, Pediatric

Diana X. Bharucha-Goebel, MD, Melissa L. Cirillo, MD and Vamshi K. Rao, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

  • A neuromuscular (NM) disease presenting with varying weakness that worsens with exercise and improves with rest

  • Three types of myasthenia gravis seen in childhood:

    • Neonatal transient

      • 10...

DIAGNOSIS

Most patients present with fluctuating ptosis that often alternates and diplopia alone or in combination with swallowing difficulties, dysphonia, and generalized weakness. 

HISTORY

  • Neonatal tr...

TREATMENT

Treat respiratory failure, a rare but serious complication of JMG. 

GENERAL MEASURES

  • Neonatal myasthenia

    • Severity of disability should be used to guide aggressiveness of therapy.

    • Respiratory or ...

ONGOING CARE

  • The following medications can exacerbate myasthenia gravis:

    • Corticosteroids may worsen symptoms.

    • Aminoglycosides

    • Ciprofloxacin

    • β-Adrenergic blocking agents, including eye drops

    • Lithium

    • Procaina...

ADDITIONAL READING

  • Castro D, Derisavifard S, Anderson M, et al. Juvenile myasthenia gravis: a twenty-year experience. J Clin Neuromuscul Dis.  2013;14(3):95–102. [View Abstract on OvidInsights]

  • Ha...

CODES

ICD9

  • 358.00 Myasthenia gravis without (acute) exacerbation

  • 775.2 Neonatal myasthenia gravis

  • 358.01 Myasthenia gravis with (acute) exacerbation

ICD10

  • G70.00 Myasthenia gravis without (acute) exacerbat...

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